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Amazon, Berkshire, JPMorgan to Create Healthcare Company

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Re: Amazon, Berkshire, JPMorgan to Create Healthcare Company

#91

Post by prklmn »

tdees40 wrote: post #82
prklmn wrote: post #81

Earlier quoted context omitted.

Buffet is the same guy that "fixed" other insurance markets by driving them away from mutual ownership to privately owned companies - a massive wealth transfer away from the common man. He shouldn't be commenting on tapeworms.

I'm genuinely fascinated by this comment. You're saying that mutuals offer lower prices (not typically true), but they were out-competed by private companies? I'm not sure that makes sense. In my sector (life insurance), there's no real pattern to mutual vs public company pricing, but maybe it's different in auto insurance, for instance.

It goes beyond pricing. Mutual insurance policy owners were paid dividends based on principle investment. Berkshire pays dividends to shareholders, i.e. Warren Buffet, while policy holders get nothing but insurance coverage.

Re: Amazon, Berkshire, JPMorgan to Create Healthcare Company

#92

Post by brittohalloran »

criddell wrote: post #28
adventured wrote: post #11

Earlier quoted context omitted.

The US healthcare system worked for the majority of people until roughly the last 15 years, and then it began failing gradually up the income ladder. So if you look more recently, the last ten years in particular, that would be the window where something like this would especially begin to matter. It wasn't done before, because it didn't make sense for large entities to bother; things have gotten bad enough that now…

> Today it's closer to $18,000. Do you happen to know the sources of inflation? Are we consuming a lot more services? Are healthcare providers being paid more? Are healthcare companies getting rich?

As a 10 year engineer in the medical device industry I've slowly come to believe the root cause is not greed for more profit, but actually runaway altruism.

All across healthcare, providers, scientists, administrators are faced with millions of tiny choices every day: should we spend more money to improve outcomes. Should we add that extra feature to this device - costs more but improves care a little. Should we use this more expensive material - costs more but is probably safer. Should we do additional testing - costs more but we'll be more sure it's safe. The calculus of incremental value vs. cost is subconsciously seen as inhumane across the industry -- it's seen as starting down that slippery slope that ends with a "dollars per life" number which feels wrong to everyone. Nobody wants to be the person who traded someone's health for a buck.

I'm not necessarily condemning it, I want the best possible care for my children, but I do think that (like a lot of big socioeconomic problems) this comes back to incentives.

Re: Amazon, Berkshire, JPMorgan to Create Healthcare Company

#93

Post by chimeracoder »

cptskippy wrote: post #54
robbiemitchell wrote: post #13

Earlier quoted context omitted.

One of the benefits a profit motive brings to insurance companies is pushing back on improper billing by providers (doctors/hospitals) and negotiating lowest possible care and drug rates. Tech-focused insurers like Oscar also invest heavily to help guide members toward better care paths, which if done well lead to better care at less expense (for both the member and insurer). Unrelated: one of the worst parts of insu…

> One of the benefits a profit motive brings to insurance companies is pushing back on improper billing by providers And one of the reasons for the most complicated billing system in the world is for-profit Insurance companies.

> And one of the reasons for the most complicated billing system in the world is for-profit Insurance companies.

Not really. In fact, Medicare is responsible for most of the current billing system, not private insurers.

Re: Amazon, Berkshire, JPMorgan to Create Healthcare Company

#94

Post by brudgers »

One reason this is likely to be less expensive is that the employees of those companies tend to be well paid and to have had ongoing access to health care. Essential tasks ordinarily done by the working poor are usually outsourced. In the case of Amazon, it's not just things like facilities maintenance and janitorial workers that won't fall under its health care umbrella, it's all those warehouse workers engaged in physical work.

Essentially, the costs will be lower because the new company will cherry pick. And again in the case of Amazon, the tendency to hire young workers also works in favor of lower costs. This is disruption in the same sense that Amazon's pillaging the public purse for its new headquarters is disruption.

Re: Amazon, Berkshire, JPMorgan to Create Healthcare Company

#95

Post by rgoddard »

_m8fo wrote: post #6

I've always wondered what's stopping someone from creating a non-profit and just having people join it in order to give the non-profit ability to negotiate lower prices. I imagine there's a cost to set this up, but is that cost less than the marginal cost of each employee and the savings they would (presumably) receive if enough people joined?

The cost of insurance is largely driven by the underlying cost of what you are insuring. Unless they are able to lower the cost of care significantly, the price difference between a non-profit and for-profit is marginal.

Re: Amazon, Berkshire, JPMorgan to Create Healthcare Company

#96

Post by jrs95 »

TillE wrote: post #47
kikoreis wrote: post #5

Tragedy of the commons much? It's disturbing to see corporations occupy the vacuum US policy has left here.

I do think it's very odd for any company to be making big bets on private health insurance when that system isn't going to exist in another 5-10 years. The ACA was the last stab at leaving private insurers in charge of a somewhat more regulated system, and it failed.

Personally I'd be surprised if it doesn't still exist within the next 20 years. I don't think that much has changed in regards to how much political power this industry has. Just because the people are starting to get on board with single payer doesn't mean the politicians are going to care.

Re: Amazon, Berkshire, JPMorgan to Create Healthcare Company

#97

Post by chimeracoder »

SkyPuncher wrote: post #46
_m8fo wrote: post #6

I've always wondered what's stopping someone from creating a non-profit and just having people join it in order to give the non-profit ability to negotiate lower prices. I imagine there's a cost to set this up, but is that cost less than the marginal cost of each employee and the savings they would (presumably) receive if enough people joined?

> I've always wondered what's stopping someone from creating a non-profit and just having people join it in order to give the non-profit ability to negotiate lower prices. Likely the fact that many of these prices are basically standardized because of CMS. Providers basically look to what the Medicare/Medicaid standard is as a benchmark for pricing. As a provider why accept a lower price from insurance when the gov't…

> As a provider why accept a lower price from insurance when the gov't is providing a backlog of people at predetermined prices?

This isn't even an option on the table. Private insurers are generally required by law to pay more than Medicare does.

And besides, Medicare reimburses rates that are below COGS, so providers charge private insurers more in order to make up the difference. Otherwise, they wouldn't be able to accept Medicare patients at all; they'd literally lose money on a per patient basis.

Re: Amazon, Berkshire, JPMorgan to Create Healthcare Company

#99

Post by ceejayoz »

brittohalloran wrote: post #92
criddell wrote: post #28

Earlier quoted context omitted.

> Today it's closer to $18,000. Do you happen to know the sources of inflation? Are we consuming a lot more services? Are healthcare providers being paid more? Are healthcare companies getting rich?

As a 10 year engineer in the medical device industry I've slowly come to believe the root cause is not greed for more profit, but actually runaway altruism. All across healthcare, providers, scientists, administrators are faced with millions of tiny choices every day: should we spend more money to improve outcomes. Should we add that extra feature to this device - costs more but improves care a little. Should we use…

Good outcomes don't have to be expensive. Europe spends half what we do per-capita on healthcare, with similar (and often better) overall outcomes.

Re: Amazon, Berkshire, JPMorgan to Create Healthcare Company

#100

Post by justjash »

After my wife giving birth last year, I would say there is quite a bit of room for improvement. The whole billing process is such a mess when you receive different bills from doctors, the hospital, labs, etc. It seemed like the bills rolled in for months afterward, some going through insurance and some not even being billed to insurance.

Happy to have insurance after I saw the total bill, but man is it a huge headache.

I hope they figure something out if we never make it to a single payer type system.

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